Male Hormone Levels and Development Issues in Young Men

Hello?

Hello Dr.
Hsu, this is the person who previously expressed concerns, 小昌.
I hope you remember me (I asked you about being 20 years old and feeling like my genitalia hasn't developed).
I really appreciate your previous response.
A few days ago, I went to the urology department for an examination at Taichung Hospital (since I study in Taichung).
The doctor said my testicles looked fine (size is okay, although I still feel they are small), but my penis is indeed a bit short (development seems poor).
Although the size when erect does not affect sexual activity (since I have an erection size of 11 cm, just a bit lacking in girth), the doctor conducted a testosterone test (blood was drawn between 8 AM and 10 AM, as the doctor said that’s when testosterone levels are highest).
When I returned for a follow-up a few days ago, I secretly looked at the report, and there was a testosterone level of only 4.
The doctor mentioned that while my level is lower than average for my age, it is still within the normal range, but he is unsure why I have poor development, so he referred me to the endocrinology department for further evaluation.
Should I consider testosterone supplementation? (My beard grows very slowly! Especially on my chin, which has not grown at all.) Can diet and exercise help increase testosterone levels? Recently, I have been feeling a lack of sexual desire and sometimes my erections are not firm enough (it feels different from before).
Is this related to testosterone levels? (It feels very different from before.) Or could it be a consequence of previous masturbation? (I haven’t masturbated in a long time.) I apologize, Dr.
Hsu, for asking so many questions because I feel anxious.
I would really like to have you examine me (because I think you are a good doctor, unlike the one at Taichung Hospital who had a poor attitude...).
It’s just unfortunate that the distance is a bit far.
I hope that being young still gives me a chance, and I regret my past behavior regarding masturbation.

Xiao Chang, 20~29 year old female. Ask Date: 2009/03/28

Dr. Xu Weikai reply Urology

Hello, have you had a semen analysis done? If not, you can go to a nearby laboratory or medical facility for a semen analysis.
The length of the penis, pubic hair, and size of the testicles can all be traced back to underlying causes, as they are related to endocrine control.
However, general practitioners (including myself) encounter such patients infrequently, and each time we do, we often need to refer to textbooks, which may lead to some omissions.
Therefore, it is best to consult a specialist.

I suggest waiting for a while, perhaps a month, and then rechecking your testosterone levels.
As for the report, you can request a copy from the physician on-site to facilitate diagnosis by other doctors.
If testosterone levels remain low, further investigation into other issues may be necessary, such as potential pituitary gland dysfunction.
There are a few urologists who conduct research in this area, but they are quite rare.
It would be advisable to first consult an endocrinologist for screening and then refer to relevant specialists if needed (for example, if there are endocrine abnormalities, determine which type; in severe cases, surgery to remove a tumor may be required, but this is just a hypothetical situation, so don't worry too much).
Additionally, it is best to seek care at a large hospital, as smaller clinics, like ours, may not have the capability to perform many tests or the necessary equipment.
Therefore, I recommend seeking care at a large medical center (there are many in the Taichung area, such as Veterans General Hospital, China Medical University Hospital, Cheng Ching Hospital, and Chung Shan Medical University Hospital).
It would also be beneficial to search online for physicians who specialize in diagnosing these issues, as that would be more appropriate.
Common endocrine tests that are typically conducted include FSH, LH, prolactin, and testosterone.
Furthermore, there is no evidence to suggest that masturbation causes erectile dysfunction or hormonal abnormalities, nor does it affect penis size.
If there are any unclear points, feel free to ask again, and we can further discuss and research the matter together.
Sincerely,
Director of Urology,
Hsu Wei-Kai,
Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2009/03/28

More Info

Understanding male hormone levels and their impact on development is crucial, especially for young men experiencing concerns about their physical development and sexual health. Testosterone, the primary male hormone, plays a significant role in various bodily functions, including the development of male reproductive tissues, increased muscle and bone mass, and the growth of body hair.
In your case, you mentioned that your testosterone levels were measured at 4 ng/mL, which, while on the lower end of the normal range for your age, is still considered within acceptable limits. However, it is essential to understand that testosterone levels can vary significantly among individuals, and factors such as genetics, lifestyle, and overall health can influence these levels.

Low testosterone levels can lead to several symptoms, including reduced libido, erectile dysfunction, fatigue, and decreased muscle mass. You also expressed concerns about the size of your penis and the growth of facial hair, which can be influenced by testosterone levels. It’s important to note that while testosterone is a critical factor in male development, other hormones and genetic factors also play a role in physical characteristics.

Regarding your concerns about whether you should supplement testosterone, it is generally not recommended to do so without a thorough evaluation by a healthcare professional. Supplementing testosterone can lead to various side effects, including infertility, increased risk of cardiovascular issues, and other hormonal imbalances. If your testosterone levels are within the normal range, it may be more beneficial to explore lifestyle changes that can naturally boost hormone levels.
Regular exercise, particularly strength training, can help increase testosterone levels. Additionally, maintaining a balanced diet rich in healthy fats, proteins, and micronutrients can support hormonal health. Foods such as lean meats, nuts, seeds, and leafy greens are excellent choices. Reducing stress through mindfulness practices or relaxation techniques can also positively impact hormone levels, as chronic stress can lead to elevated cortisol levels, which can inhibit testosterone production.

You mentioned experiencing a lack of sexual desire and occasional difficulties with erections. These issues can be multifactorial, including psychological factors such as anxiety or stress, which can significantly impact sexual health. It’s essential to address these concerns holistically, considering both physical and mental health aspects.

As for your worries about past behaviors, such as frequent masturbation, it’s important to understand that masturbation is a normal sexual activity and, in moderation, does not typically cause long-term negative effects on sexual health or hormone levels. However, if it becomes compulsive or interferes with daily life, it may be worth discussing with a healthcare professional.

If you are still concerned about your hormone levels or physical development, I recommend following up with an endocrinologist, as they can provide a more comprehensive evaluation and determine if any underlying conditions may be affecting your hormone levels. They may also suggest further testing to assess other hormones that could be influencing your testosterone levels.

In summary, while your testosterone levels are on the lower end of normal, there are various lifestyle changes you can implement to support your hormonal health. It’s crucial to approach this issue with a holistic mindset, considering both physical and psychological factors. Consulting with a healthcare professional who can guide you through this process will be beneficial in addressing your concerns and ensuring your overall well-being.

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